MEDICARE: ANNA GRATALO PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	310203	CA

General Provider Information

NPI Number	:	1013848456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA GRATALO PT, DPT

Provider Business Mailing Address
First Line	:	1912 MILLENIA AVE APT 303
Second Line	:
City	:	CHULA VISTA
State	:	CA
Zip	:	91915-3081
Country	:	US
Telephone Number	:	208-863-1615
Fax Number	:

Provider Business Practice Location Address
First Line	:	5807 UNIVERSITY AVE STE 6
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-6295
Country	:	US
Telephone Number	:	619-500-1098
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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